Abbreviated course of radiation therapy with concurrent temozolomide for high-grade glioma in patients of advanced age or poor functional status Journal Article


Authors: Reyngold, M.; Lassman, A. B.; Chan, T. A.; Yamada, Y.; Gutin, P. H.; Beal, K.
Article Title: Abbreviated course of radiation therapy with concurrent temozolomide for high-grade glioma in patients of advanced age or poor functional status
Abstract: Elderly or frail patients with high-grade gliomas (HGG) can be effectively treated with an abbreviated course of radiation therapy (RT) consisting of 40 Gy in 15 fractions. Concurrent temozolomide (TMZ) improves survival in non-elderly patients with glioblastoma treated with standard schedule of 60 Gy in 30 fractions. We describe our institutional experience of combining abbreviated RT with concurrent TMZ for treatment of HGG. Between 1/1/2004 and 2/5/2010 31 patients were treated. Survival was estimated with the Kaplan-Meier method. Toxicity was scored according to CTCAE 3.0. Median age was 66 years (range 32-90), and 17 patients had Karnofsky performance score <70. At the time of analysis, 30 patients (98 %) had died, with a followup of 14 months in the surviving patient. Median survival was 11 months (range 1-20), and 41 % of patients were alive at 12 months. Thirty patients (97 %) had a decreased corticosteroid requirement after completion of therapy. Only one new hospitalization for worsening neurologic status was required during therapy. Grade 3-4 hematologic toxicity occurred in 11 patients. Abbreviated RT with concurrent TMZ provides a clinical benefit, is safe and tolerable in patients of advanced age or poor functional status. © Springer Science+Business Media, LLC. 2012.
Keywords: adult; cancer survival; clinical article; aged; drug tolerability; neutropenia; drug efficacy; drug safety; cancer radiotherapy; radiation dose; temozolomide; cancer incidence; cancer grading; cytoreductive surgery; quality of life; computer assisted tomography; infection; anemia; blood toxicity; thrombocytopenia; lymphocytopenia; hospitalization; glioblastoma; corticosteroid; dna methyltransferase; cotrimoxazole; antibiotic prophylaxis; neurologic disease; gliosarcoma; functional status; high-grade glioma; cancer prognosis; abbreviated radiotherapy
Journal Title: Journal of Neuro-Oncology
Volume: 110
Issue: 3
ISSN: 0167-594X
Publisher: Springer  
Date Published: 2012-12-01
Start Page: 369
End Page: 374
Language: English
DOI: 10.1007/s11060-012-0972-7
PROVIDER: scopus
PUBMED: 22983908
DOI/URL:
Notes: --- - "Export Date: 2 January 2013" - "CODEN: JNODD" - "Source: Scopus"
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Timothy Chan
    317 Chan
  2. Yoshiya Yamada
    479 Yamada
  3. Philip H Gutin
    163 Gutin
  4. Kathryn Beal
    221 Beal
  5. Marsha Reyngold
    103 Reyngold